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Duration of colonization with vancomycin-resistant Enterococcus.

Karin E Byers1, Anne M Anglim, Cynthia J Anneski

  • 1University of Virginia Health System, Charlottesville 22908, USA.

Infection Control and Hospital Epidemiology
|May 11, 2002
PubMed
Summary
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Three negative cultures effectively clear vancomycin-resistant Enterococcus (VRE) colonization, but patients require monitoring for relapse, especially after antibiotic treatment. This supports current VRE isolation guidelines.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Epidemiology

Background:

  • Vancomycin-resistant Enterococcus (VRE) is a significant healthcare-associated pathogen.
  • Determining the optimal duration for VRE decolonization is crucial for infection control.

Purpose of the Study:

  • To evaluate the duration of VRE colonization.
  • To assess the adequacy of three consecutive negative cultures for VRE clearance.

Main Methods:

  • Retrospective cohort study of 116 VRE-colonized patients at a university hospital.
  • Analysis of 423 follow-up perirectal cultures collected at least one week apart, off antibiotics.
  • Statistical analysis of culture positivity based on prior results and time since initial VRE detection.

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Main Results:

  • VRE colonization duration varied, with a mean of 204 days.
  • 95% of patients remained culture-negative after two sequential negative cultures.
  • 35 of 37 patients (95%) remained culture-negative after three sequential negative cultures.

Conclusions:

  • Three sequential negative cultures, spaced at least one week apart, support the removal of patients from VRE isolation.
  • The findings may indicate a reduction to undetectable VRE levels rather than complete eradication.
  • Continued surveillance for VRE relapse is recommended, particularly in patients undergoing re-treatment with antibiotics.